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PLoS One ; 15(1): e0227175, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923188


BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is associated with an increased risk of myocardial infarction and stroke but it remains unclear how to identify microvascular changes in this population. OBJECTIVES: We hypothesized that simple non-mydriatic retinal photography is feasible and can be used to assess microvascular damage in COPD. METHODS: Novel Vascular Manifestations of COPD was a prospective study comparing smokers with and without COPD, matched for age. Non-mydriatic, retinal fundus photographs were assessed using semi-automated software. RESULTS: Retinal images from 24 COPD and 22 control participants were compared. Cases were of similar age to controls (65.2 vs. 63.1 years, p = 0.38), had significantly lower Forced Expiratory Volume in one second (FEV1) (53.4 vs 100.1% predicted; p < 0.001) and smoked more than controls (41.7 vs. 29.6 pack years; p = 0.04). COPD participants had wider mean arteriolar (155.6 ±15 uM vs. controls [142.2 ± 12 uM]; p = 0.002) and venular diameters (216.8 ±20.7 uM vs. [201.3± 19.1 uM]; p = 0.012). Differences in retinal vessel caliber were independent of confounders, odds ratios (OR) = 1.08 (95% confidence intervals [CI] = 1.02, 1.13; p = 0.007) and OR = 1.05 (CI = 1.01, 1.09; p = 0.011) per uM increase in arteriolar and venular diameter respectively. FEV1 remained significantly associated with retinal vessel dilatation r = -0.39 (p = 0.02). CONCLUSIONS: Non-mydriatic retinal imaging is easily facilitated. We found significant arteriole and venous dilation in COPD compared to age-matched smokers without COPD associated with lung function independent of standard cardiovascular risk factors. Retinal microvascular changes are known to be strongly associated with future vascular events and retinal photography offers potential to identify this risk. TRIAL REGISTRATION: NCT02060292.

Processamento de Imagem Assistida por Computador/métodos , Microvasos/diagnóstico por imagem , Fotomicrografia/métodos , Doença Pulmonar Obstrutiva Crônica/complicações , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/etiologia , Vasos Retinianos/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Estudos de Viabilidade , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Vasos Retinianos/patologia , Fumantes , Fumar/efeitos adversos
J Drugs Dermatol ; 18(12): 1231-1236, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31860211


BACKGROUND: With the advent of digital microscopy, learning analytics can be leveraged to advance teaching of dermatopathology in dermatology residency. OBJECTIVE: To analyze the acquisition and decay of dermatopathology visual recognition skills and areas of diagnostic confusion amongst residents using learning metrics generated by a web-based learning tool. METHODS: This was a prospective, longitudinal study of dermatology residents who studied digital photomicrographs of 18 routine diagnostic entities using an online software platform. Residents at different years of training were given 60 minutes to complete assessments on three occasions (initial test with follow-ups at one and three months). RESULTS: 4,938 responses were analyzed. Accuracy and time to diagnosis improved within each assessment and between the first and second assessments. First year residents showed knowledge decay when tested at three months (67% vs 64%; P=0.002) while third year residents retained knowledge and continued to improve upon their accuracy after three months (83% to 91%, <0.001). Learning analytics highlighted diagnostically challenging cases for residents that contradicted experts' predictions (R=0.48). CONCLUSIONS: The use of learning analytics and interactive digital platforms enhances dermatopathology curriculum development by identifying challenging diagnostic entities, assessing mastery of subject material, and optimizing review schedules. J Drugs Dermatol. 2019;18(12):1231-1236.

Dermatologia/educação , Internato e Residência , Fotomicrografia/métodos , Dermatopatias/diagnóstico , Competência Clínica , Currículo , Diagnóstico por Imagem/métodos , Avaliação Educacional , Humanos , Aprendizagem , Estudos Longitudinais , Microscopia/métodos , Estudos Prospectivos , Dermatopatias/patologia
Eur. j. anat ; 23(5): 315-323, sept. 2019. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-183861


Anatomic characterization and fine structure of the human ligamentum flavum (LF), especially at different spinal levels, represent an attractive focus for the scientific and surgical application. Descriptive anatomical and structural study of LF at the cervical, thoracic and lumbar levels of the vertebral column in human cadavers is carried out here. The aim of the work is to clarify the anatomical features and fine structural differences in the human LF at different vertebral levels (cervical, thoracic and lumbar). Specimens of vertebral column were obtained from 34 human preserved cadavers. Their average age ranged between 56 and 69 years. Morphometric parameters including height, width and thickness of the ligament flavum at the midlevels of cervical, thoracic and lumbar regions were measured. Sections obtained from different levels were stained with different stains. Morphometric measurements involved the relative elastic area, relative collagen area, elastic area and collagen area% were measured.The results of the height, width and thickness of the LF at different spinal levels showed gradual increase in their mean values respectively. The LF midline gaps were found in the cervical, thoracic and lumbar regions. The morphometrical measurements showed that the average elastic area was highest in the cervical region and lowest in the thoracic region. In the lumbar region, the percentages of both elastic area and the collagen area were nearly the same. The characterization of morphological and histological aspects of the LF at different spinal levels will be of great importance for applications in spinal surgery, biomechanical and physical rehabilitation of vertebral column

No disponible

Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Ligamento Amarelo/anatomia & histologia , Plexo Cervical/anatomia & histologia , Vértebras Lombares/anatomia & histologia , Cadáver , Tecido Elástico/anatomia & histologia , Dissecação/instrumentação , Estudos Transversais , Fotomicrografia/métodos
Toxicol Pathol ; 47(5): 634-644, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31409263


Reliable detection and measurement of cell proliferation are essential in the preclinical assessment of carcinogenic risk of therapeutics. In this context, the assessment of mitogenic potential on mammary glands is crucial in the preclinical safety evaluation of novel insulins. The existing manual counting is time-consuming and subject to operator bias. To standardize the processes, make it faster, and resistant to errors, we developed a semiautomated image analysis system (CEPA software, which is open-source) for counting of proliferating cells in photomicrographs of mammary gland sections of rats labeled with Ki-67. We validated the software and met the predefined targets for specificity, accuracy, and reproducibility. In comparison to manual counting, the respective mean differences in absolute labeling indices (LIs) for CEPA software were 3.12% for user 1 and 3.05% for user 2. The respective regression analysis revealed a good correlation between the CEPA software user and manual counting. Moreover, the CEPA software showed enhanced reproducibility between independent users. The interuser variability is centered around 0 and the absolute difference was about 0.53% LI. Based on validation data, our software has superiority to the manual counting and is a valid and reliable tool for the routine analysis of cell proliferation in mammary glands from rats exposed to insulin analogs.

Proliferação de Células/efeitos dos fármacos , Processamento de Imagem Assistida por Computador/métodos , Glândulas Mamárias Animais/diagnóstico por imagem , Fotomicrografia/métodos , Animais , Avaliação Pré-Clínica de Medicamentos/métodos , Avaliação Pré-Clínica de Medicamentos/normas , Feminino , Processamento de Imagem Assistida por Computador/normas , Insulina/análogos & derivados , Insulina/toxicidade , Glândulas Mamárias Animais/efeitos dos fármacos , Glândulas Mamárias Animais/patologia , Fotomicrografia/normas , Ratos Sprague-Dawley , Reprodutibilidade dos Testes , Software , Testes de Toxicidade/métodos , Testes de Toxicidade/normas
Aesthetic Plast Surg ; 43(1): 233-242, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30276460


BACKGROUND: One of the undesirable complications that might occur after breast augmentation with silicone implants is capsular contracture. In its etiology, the relations between mast cells and myofibroblasts play an important role in collagen synthesis. Mast cells are able to activate fibroblasts into myofibroblasts, through paracrine secretions, inducing collagen production. The objectives of this study were to analyze the myofibroblast concentration through the α-SMA immunomarker and evaluate the intensity of mast cell expression against the C-Kit immunomarker. MATERIAL AND METHOD: Sixty-four Wistar rats were used, divided into two groups (polyurethane foam and textured surface) with 32 animals in each. The animals received silicone implants on the back, below the panniculus carnosus, and after the determined period, they were killed and the capsules formed around the implants were studied. The capsules were analyzed employing the immunohistochemical technique, with the α-SMA and C-Kit immunomarkers in subgroups of 30, 50, 70 and 90 days. RESULTS: The myofibroblast concentration was higher in the polyurethane group when compared to the textured group (30 days p = 0.105; 50 days p = 0.247; 70 days p = 0.014 and 90 days p = 0.536). The intensity of mast cell expression was more pronounced in the polyurethane group when compared to the textured group (30 days p = 0.798; 50 days p = 0.537; 70 days p = 0.094 and 90 days p = 0.536). CONCLUSIONS: Polyurethane-coated implants induced higher concentrations of myofibroblasts and higher expression of mast cells, when compared to the textured surface implants. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors .

Actinas/imunologia , Implante Mamário/efeitos adversos , Contratura Capsular em Implantes/patologia , Poliuretanos/efeitos adversos , Proteínas Proto-Oncogênicas c-kit/imunologia , Géis de Silicone/efeitos adversos , Animais , Biomarcadores/metabolismo , Implante Mamário/métodos , Modelos Animais de Doenças , Feminino , Imuno-Histoquímica , Contratura Capsular em Implantes/etiologia , Músculo Liso/imunologia , Músculo Liso/patologia , Fotomicrografia/métodos , Distribuição Aleatória , Ratos , Ratos Wistar , Sensibilidade e Especificidade
Cornea ; 38(1): 110-119, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30308581


PURPOSE: Loss of corneal endothelial cells (CECs) bears disastrous consequences for the patient, including corneal clouding and blindness. Corneal transplantation is currently the only therapy for severe corneal disorders. However, the worldwide shortages of corneal donor material generate a strong demand for personalized stem cell-based alternative therapies. Because human mesenchymal stem cells are known to be sensitive to their mechanical environments, we investigated the mechanotransductive potential of Descemet membrane-like microtopography (DLT) to differentiate human mesenchymal stem cells into CEC-like cells. METHODS: Master molds with inverted DLT were produced by 2-photon lithography (2-PL). To measure the mechanotransductive potential of DLT, mesenchymal stem cells were cultivated on silicone or collagen imprints with DLT. Changes in morphology were imaged, and changes in gene expression of CEC typical genes such as zonula occludens (ZO-1), sodium/potassium (Na/K)-ATPase, paired-like homeodomain 2 (PITX2), and collagen 8 (COL-8) were measured with real-time polymerase chain reaction. At least immunofluorescence analysis has been conducted to confirm gene data on the protein level. RESULTS: Adhesion of MSCs to DLT molded in silicone and particularly in collagen initiates polygonal morphology and monolayer formation and enhances not only transcription of CEC typical genes such as ZO-1, Na/K-ATPase, PITX2, and COL-8 but also expression of the corresponding proteins. CONCLUSIONS: Artificial reproduction of Descemet membrane with respect to topography and similar stiffness offers a potential innovative way to bioengineer a functional CEC monolayer from autologous stem cells.

Doenças da Córnea/cirurgia , Transplante de Córnea , Lâmina Limitante Posterior/ultraestrutura , Epitélio Posterior/ultraestrutura , Células-Tronco Mesenquimais/ultraestrutura , Fotomicrografia/métodos , Animais , Biomimética , Contagem de Células , Células Cultivadas , Doenças da Córnea/patologia , Citometria de Fluxo , Humanos , Masculino , Microscopia Eletrônica de Varredura , Coelhos
Full dent. sci ; 10(39): 107-112, 2019. ilus
Artigo em Português | BBO - Odontologia | ID: biblio-1024724


Os osteomas são tumores benignos de crescimento ósseo, compostos de osso compacto, esponjoso ou misto, comumente associado ao esqueleto craniofacial, com maior frequência nos seios paranasais e menor frequência nos ossos gnáticos. Tem predileção pelo sexo masculino entre a segunda e quinta décadas de vida. Sua etiologia é incerta, podendo estar associada à infecção, trauma, influência genética ou embriológica. O tratamento cirúrgico dos osteomas está reservado para os casos de crescimento rápido, infecção, sintomatologia dolorosa, alteracões funcionais ou deformidades estéticas. Casos de osteomas pequenos e assintomáticos permitem tratamento conservador. O presente trabalho tem por objetivo relatar um caso de osteoma em seio maxilar associado à sintomatologia dolorosa (cefaleia) tratado cirurgicamente (AU).

Osteomas are benign tumors of bone growth, composed of compact, spongy or mixed bones, commonly associated with the craniofacial skeleton, more frequently in the paranasal sinuses and less frequently in the gnathic bones. It mostly affects men between 20 and 50 years old. Its etiology is uncertain and may be associated with infection, trauma, genetic or embryological influence. Surgical treatment of osteomas is reserved for cases of rapid growth, infection, painful symptomatology, functional alterations or aesthetic deformities. Cases of small asymptomatic osteomas allow conservative treatment. The present study aims to report a case of osteoma in the maxillary sinus associated with painful symptomatology (headache) treated surgically (AU).

Humanos , Masculino , Pessoa de Meia-Idade , Osteoma/etiologia , Seios Paranasais , Cirurgia Bucal , Neoplasias do Seio Maxilar/diagnóstico , Seio Maxilar , Brasil , Fotomicrografia/métodos , Radiografia Panorâmica/instrumentação
J Vis Exp ; (140)2018 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-30371667


Renal micropuncture and renal 2-photon imaging are seminal techniques in renal physiology. However, micropuncture is limited by dependence on conventional microscopy to surface nephron features, and 2-photon studies are limited in that interventions can only be assessed at the organ, rather than the nephron level. In particular, micropuncture studies of the glomeruli of mice have been challenged by the paucity of surface glomeruli in mice. To address this limitation in order to pursue studies of aspirate from Bowman's space in mouse physiologic models, we developed 2-photon glomerular micropuncture. We present a novel surgical preparation that allows lateral access to the kidney while preserving the required vertical imaging column for 2-photon microscopy. Administration of high molecular weight fluorescein isothiocyanate (FITC)-dextran is used to render the renal vasculature and therefore glomeruli visible for 2-photon imaging. A quantum dot-coated pipette is then introduced under stereotactic guidance to a glomerulus selected from the several to many which may be visualized within the imaging window. In this protocol, we provide details of the preparation, materials, and methods necessary to carry out the procedure. This technique facilitates previously-impossible physiologic study of the kidney, including recovery of filtrate from Bowman's space and all segments of the nephron within the imaging depth limit, about 100 µm below the renal capsule. Pressure, charge and flow may all be measured using the introduced pipette. Here, we provide representative data from liquid chromatography/mass spectrometry performed on aspirate from Bowman's space. We expect this technique to have wide applicability in renal physiologic investigation.

Glomérulos Renais/diagnóstico por imagem , Fotomicrografia/métodos , Punções/métodos , Animais , Nefropatias , Glomérulos Renais/fisiologia , Camundongos
Heart Surg Forum ; 21(3): E148-E150, 2018 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-29893670


OBJECTIVE: Our objective is to summarize our experience in the diagnosis and treatment of Lambl's excrescence (LE) on the aortic valve. Methods: The clinical data of 25 patients with LE admitted to our hospital from January 2010 to December 2014 were analyzed retrospectively. There were 17 males and 8 females, with the mean age of 55.7 ± 11.43 years (range: 30 to 70 years). Among the patients analyzed, eight also had cerebral embolism. All of the patients were diagnosed by transesophageal echocardiography (TEE). In seven cases, surgical treatment to remove the excrescence was successfully performed. Results: All 25 patients were cured and discharged. There were no complications or operative mortalities in the seven patients that underwent surgical treatment. Follow-ups were performed for all patients for an average of 2.9 ± 1.5 years. During this time, none had a new cerebrovascular accident (CVA). Conclusions: Most patients with LE are asymptomatic, though some patients showed repeated episodes of stroke. We recommend TEE as the main diagnostic means of the disease. Patients with LE that have experienced two or more CVAs or combined other heart disease and need open heart surgery should be offered surgical excision of the excrescences. Other patients should be treated conservatively with anticoagulation, or monitored closely.

Valva Aórtica/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia Transesofagiana/métodos , Doenças das Valvas Cardíacas/cirurgia , Fotomicrografia/métodos , Adulto , Idoso , Valva Aórtica/diagnóstico por imagem , Feminino , Fibrose/diagnóstico , Fibrose/cirurgia , Doenças das Valvas Cardíacas/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
J Vis Exp ; (136)2018 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-29939190


Microglia are brain phagocytes that participate in brain homeostasis and continuously survey their environment for dysfunction, injury, and disease. As the first responders, microglia have important functions to mitigate neuron and glia dysfunction, and in this process, they undergo a broad range of morphologic changes. Microglia morphologies can be categorized descriptively or, alternatively, can be quantified as a continuous variable for parameters such as cell ramification, complexity, and shape. While methods for quantifying microglia are applied to single cells, few techniques apply to multiple microglia in an entire photomicrograph. The purpose of this method is to quantify multiple and single cells using readily available ImageJ protocols. This protocol is a summary of the steps and ImageJ plugins recommended to convert fluorescence and bright-field photomicrographs into representative binary and skeletonized images and to analyze them using software plugins AnalyzeSkeleton (2D/3D) and FracLac for morphology data collection. The outputs of these plugins summarize cell morphology in terms of process endpoints, junctions, and length as well as complexity, cell shape, and size descriptors. The skeleton analysis protocol described herein is well suited for a regional analysis of multiple microglia within an entire photomicrograph or region of interest (ROI) whereas FracLac provides a complementary individual cell analysis. Combined, the protocol provides an objective, sensitive, and comprehensive assessment tool that can be used to stratify between diverse microglia morphologies present in the healthy and injured brain.

Imuno-Histoquímica/métodos , Microglia/metabolismo , Fotomicrografia/métodos , Animais , Camundongos , Microglia/citologia , Ratos
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 29(2): 64-78, mar.-abr. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-171431


Objetivo: Describir y discutir el papel del tratamiento quirúrgico en la espondilodiscitis espontánea. Pacientes y métodos: Análisis retrospectivo de resultados y complicaciones de una cohorte de pacientes intervenidos por espondilodiscitis espontánea (no posquirúrgica) de cualquier nivel espinal y etiología. Resultados: En el período 1995-2014 se trataron 83 pacientes (45% mujeres, edad mediana 66 años) con diagnóstico de espondilodiscitis (confirmación microbiológica en el 67,4%). Existió déficit neurológico preoperatorio en el 44,5%. El nivel más frecuentemente afectado fue el dorsal (54,2%). Los principales gérmenes aislados fueron Mycobacterium tuberculosis (22,9%), Staphylococcus aureus (20,5%) y SARM (7,2%). Se intervinieron 81 pacientes mediante: laminectomía simple y/o biopsia (22,2%), laminectomía, desbridamiento y artrodesis posterior (43,2%), y desbridamiento y fijación anterior (34,5%). El 86,7% de los pacientes intervenidos obtuvieron buena evolución postoperatoria (mejoría sintomática o del déficit). Se estabilizaron 7 pacientes y empeoraron 2. Aparecieron complicaciones en 35 pacientes, fundamentalmente derrame pleural (9), anemia (7) y necesidad de reintervención y desbridamiento (7). La mediana de estancia postoperatoria fue de 14 días. Tras un seguimiento medio de 8,5 meses se consideraron curados 46 pacientes, 10 presentaron secuelas, se perdieron 22 pacientes y 5 fallecieron. La cirugía no motivó reingresos. Conclusiones: Aunque la antibioterapia específica y prolongada es el tratamiento estándar, la cirugía permite obtener muestra para estudio microbiológico e histopatológico, desbridar el foco infeccioso y estabilizar la columna. En nuestra experiencia la utilización de material metálico de fijación acelera la recuperación y no predispone a ulteriores infecciones o a cronificación de las mismas

Objective: To describe and discuss the role of surgery in the management of spontaneous spondylodiscitis. Patients and methods: Retrospective review on the outcome and complications of a cohort of patients undergoing surgery for spontaneous (non-postoperative) spondylodiscitis of any spinal level or aetiology. Results: From 1995 to 2014, 83 patients (45% females, median age 66) with spondylodiscitis were treated. Microbiological confirmation was obtained in 67.4%. Forty-four percent of patients presented with neurological defect. The most common affected level was thoracic (54.2%). The most frequent isolations were Mycobacterium tuberculosis (229%), Staphylococcus aureus (20.5%) and MRSA (7.2%). Eighty-one patients underwent surgery: simple laminectomy and/or biopsy (22.2%), debridement and posterior fixation (43.2%) and debridement and anterior fixation (34.5%). Improvement of pain or neurological defect was achieved in 86.7% of the patients; 7 patients stabilized and 2 worsened. Complications occurred in 35 patients, mainly pleural effusion (9), anaemia (7) and need for re-debridement (7). Median postoperative stay was 14 days. After a median follow up of 8.5 months, 46 patients were considered completely cured, 10 presented sequelae, 22 patients were lost and 5 patients died. No readmissions occurred because of the infectious episode. Conclusions: Although prolonged and specific antibiotic therapy remains the mainstay of treatment in spontaneous spondylodiscitis, surgery provides samples for microbiological confirmation and histopathologic study, allows debridement of the infectious foci and stabilizes the spine. In our experience, the use of internal metallic fixation material accelerates recovery and does not predispose to chronic infection

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Discite/diagnóstico por imagem , Discite/cirurgia , Infecções/complicações , Inflamação/complicações , Estudos de Coortes , Staphylococcus aureus/isolamento & purificação , Staphylococcus aureus Resistente à Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Tempo de Internação , Imagem por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodos , Fotomicrografia/métodos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 29(2): 79-85, mar.-abr. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-171432


Antecedentes y objetivo: El uso de escalas de degeneración histológica de las hernias discales lumbares intervenidas quirúrgicamente es poco frecuente en la práctica clínica y su empleo se ha limitado fundamentalmente al ámbito de la investigación. El objetivo del trabajo es valorar si existe relación entre un mayor grado de degeneración histológica cuando se compara con variables clínicas o escalas radiológicas. Pacientes y método: Análisis retrospectivo de 122 pacientes consecutivos intervenidos por hernia discal lumbar monosegmentaria, de todos los cuales se dispone de información clínica y en 75 pacientes además se ha recuperado el estudio histológico y la resonancia magnética prequirúrgica. Las variables clínicas recogidas incluyen la edad, el tiempo de evolución de la sintomatología, el déficit neurológico o el reflejo osteotendinoso afectado. La resonancia magnética ha sido evaluada utilizando las escalas de Pfirrmann y Modic para el segmento intervenido por 2 observadores independientes. La degeneración histológica se ha evaluado utilizando la escala de Weiler; además se ha estudiado la presencia de infiltrados inflamatorios y la formación de neovasos, no incluidos en esta escala. Se han utilizado pruebas de correlación y de chi-cuadrado para valorar la asociación entre las variables histológicas y las clínicas o radiológicas. Se ha evaluado también la concordancia entre observadores en las variables de resonancia magnética mediante el índice kappa ponderado. Resultados: No se ha hallado ninguna relación estadísticamente significativa entre las variables histológicas (puntuación de la escala de degeneración discal, infiltrados inflamatorios, presencia de vasos neoformados) y las variables clínicas o las escalas radiológicas. La concordancia entre los 2 observadores para las escalas radiológicas resultó en un kappa de 0,79 para la escala de Pfirrmann, y de 0,65 para la de Modic, ambas estadísticamente significativas. Conclusiones: En nuestra serie de pacientes no parece existir una relación entre el grado de degeneración histológica o la presencia de infiltrados inflamatorios cuando se evalúa su relación con escalas radiológicas de degeneración discal o con variables clínicas como la edad o el tiempo de evolución de los síntomas

Background and objective: The use of histological degeneration scores in surgically-treated herniated lumbar discs is not common in clinical practice and its use has been primarily restricted to research. The objective of this study is to evaluate if there is an association between a higher grade of histological degeneration when compared with clinical or radiological parameters. Patients and method: Retrospective consecutive analysis of 122 patients who underwent single-segment lumbar disc herniation surgery. Clinical information was available on all patients, while the histological study and preoperative magnetic resonance imaging were also retrieved for 75 patients. Clinical variables included age, duration of symptoms, neurological deficits, or affected deep tendon reflex. The preoperative magnetic resonance imaging was evaluated using Modic and Pfirrmann scores for the affected segment by 2 independent observers. Histological degeneration was evaluated using Weiler's score; the presence of inflammatory infiltrates and neovascularization, not included in the score, were also studied. Correlation and chi-square tests were used to assess the association between histological variables and clinical or radiological variables. Interobserver agreement was also evaluated for the MRI variables using weighted kappa. Results: No statistically significant correlation was found between histological variables (histological degeneration score, inflammatory infiltrates or neovascularization) and clinical or radiological variables. Interobserver agreement for radiological scores resulted in a kappa of 0.79 for the Pfirrmann scale and 0.65 for the Modic scale, both statistically significant. Conclusions: In our series of patients, we could not demonstrate any correlation between the degree of histological degeneration or the presence of inflammatory infiltrates when compared with radiological degeneration scales or clinical variables such as the patient's age or duration of symptoms

Humanos , Masculino , Feminino , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Inflamação/diagnóstico por imagem , Discotomia/métodos , Estudos Retrospectivos , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/cirurgia , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/cirurgia , Fotomicrografia/métodos
J Cutan Pathol ; 45(6): 412-415, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29484692


The objective of our study was to establish a detailed photomicrographing protocol for pathologists and dermatopathologists using standard overhead camera and image editing packages. Through a trial-and-error approach we devised a series of steps that comprise our photomicrographing protocol. Descriptive and interpretive data analyses were performed to highlight how each step improves tinctorial quality of digital photomicrographs.

Dermatologia/métodos , Processamento de Imagem Assistida por Computador/métodos , Patologia/métodos , Fotomicrografia/métodos , Telefone Celular , Humanos , Software
Rev. int. androl. (Internet) ; 15(4): 165-168, oct.-dic. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-166863


La neoplasia testicular intratubular es una lesión premaligna testicular asociada a tumores germinales primarios gonadales y extragonadales. La prevalencia de neoplasia testicular intratubular en pacientes infértiles llega al 2% en diferentes estudios. Presentamos el caso de un paciente azoospérmico con diagnóstico incidental de neoplasia testicular intratubular bilateral en la biopsia testicular realizada durante la recuperación quirúrgica de espermatozoides. En pacientes infértiles, las técnicas de recuperación espermática deben incluir el estudio anatomopatológico de parénquima testicular para descartar enfermedad maligna asociada. Los pacientes con alteración de la espermatogénesis tienen mayor riesgo de presentar otras alteraciones del desarrollo gonadal (neoplasias, hipogonadismo, entre otros) en el contexto de un síndrome de disgenesia testicular (AU)

Testicular intraepithelial neoplasia is a premalignant lesion associated to gonadal and extragonadal germ cell tumors. Testicular intraepithelial neoplasia prevalence in infertile men has reached 2% in some studies. This report presents the case of an azoospermic man with an incidental diagnosis of bilateral testicular intraepithelial neoplasia after testicular sperm extraction. In infertile men, sperm retrieving techniques have to include histological analysis of testicular tissue, to discard any chance of malignant component. Patients with spermatogenesis alterations have an increased risk to present other disruptions in gonadal development (neoplasms, hypogonadism, among others) in the context of testicular dysgenesis syndrome (AU)

Humanos , Masculino , Adulto , Neoplasias Testiculares/complicações , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/cirurgia , Infertilidade Masculina/complicações , Espermatogênese , Biópsia , Azoospermia/complicações , Azoospermia/diagnóstico , Imuno-Histoquímica/métodos , Fotomicrografia/métodos , Testículo/patologia
Rev. esp. patol ; 50(2): 113-123, abr.-jun. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-161088


Un adecuado conocimiento y comprensión del concepto de planos conjugados es de capital importancia en la utilización del microscopio por cuanto que desde hace ya bastante tiempo el diseño de los microscopios se basa en la correcta situación de sus dos conjuntos de planos conjugados. En 1893 August Köhler publicó el trabajo «Un nuevo sistema de iluminación en microfotografía» donde dio a conocer los fundamentos básicos de una técnica de iluminación que actualmente lleva su nombre. El conocimiento y aplicación de los principios del sistema de iluminación de Köhler constituye el elemento de mayor importancia en el correcto manejo de un microscopio. Dichos principios no siempre son bien conocidos y comprendidos por los usuarios del microscopio constituyendo una fuente frecuente de errores en microscopía, particularmente en microfotografía. En este artículo revisamos los principios básicos del concepto de planos conjugados y del sistema de iluminación de Köhler (AU)

Adequate knowledge and understanding of the concept of conjugate planes is of paramount importance in the use of the microscope and for a long time microscope design was based on the correct location of the two sets of conjugate planes. In 1893 August Köhler published the article «A new illumination system in microphotography» in which he introduced the basics of an illumination technique that now bears his name. The knowledge and application of the principles of the Köhler illumination system is the most important element in the proper handling of a microscope. These principles are not always well known or understood by the users of microscopes, frequently leading to errors in microscopy, particularly in photomicrography. This article reviews the basic principles of the concept of conjugate planes and Köhler illumination system (AU)

Humanos , Masculino , Feminino , Idoso , Iluminação/métodos , Iluminação/normas , Microscopia/instrumentação , Microscopia/métodos , Fotomicrografia/instrumentação , Fotomicrografia/métodos , Imagem Óptica/tendências , Tomografia com Microscopia Eletrônica/métodos , Fotomicrografia/tendências
J Vis Exp ; (122)2017 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-28447990


The Golgi-Cox method of neuron staining has been employed for more than two hundred years to advance our understanding of neuron morphology within histological brain samples. While it is preferable from a practical perspective to prepare brain sections at the greatest thickness possible, in order to increase the probability of identifying stained neurons that are fully contained within single sections, this approach is limited from a technical perspective by the working distance of high-magnification microscope objectives. We report here a protocol to stain neurons using the Golgi-Cox method in mouse brain sections that are cut at 500 µm thickness, and to visualize neurons throughout the depth of these sections using an upright microscope fitted with a high-resolution 30X 1.05 N.A. silicone oil-immersion objective that has an 800 µm working distance. We also report two useful variants of this protocol that may be employed to counterstain the surface of mounted brain sections with the cresyl violet Nissl stain, or to freeze whole brains for long-term storage prior to sectioning and final processing. The main protocol and its two variants produce stained thick brain sections, throughout which full neuron dendritic trees and dendrite spines may be reliably visualized and quantified.

Encéfalo/citologia , Neuroimagem/métodos , Coloração pela Prata/métodos , Animais , Benzoxazinas , Encéfalo/fisiologia , Corantes , Espinhas Dendríticas , Feminino , Camundongos , Microscopia/instrumentação , Microscopia/métodos , Neuroimagem/instrumentação , Neurônios/citologia , Neurônios/fisiologia , Fotomicrografia/métodos
Rev. esp. patol ; 50(1): 58-63, ene.-mar. 2017.
Artigo em Espanhol | IBECS | ID: ibc-159066


La coexistencia de 2 o más tumores en un paciente es un hecho poco frecuente y más infrecuentes son las metástasis de tumor a tumor. La mayoría de las publicaciones incluyen hallazgos autópsicos y, en menor número, hallazgos en piezas quirúrgicas-biopsias. El origen primario más frecuente es el carcinoma de pulmón, siendo el receptor más frecuente el carcinoma de células claras renal. Describimos el caso de una paciente de 54años con historia remota de carcinoma ductal infiltrante de mama derecha, que presentó en el transcurso afectación metastásica a nivel pulmonar, ganglionar, óseo y hace 3 meses una lesión en riñón derecho. Se sometió a nefrectomía. El estudio anatomopatológico reveló un carcinoma renal de células cromófobas con metástasis intratumoral de carcinoma ductal infiltrante de mama. Se describen los hallazgos histológicos, inmunohistoquímicos y moleculares, con revisión de la literatura reciente (AU)

The coexistence of two or more tumours in the same patient is unusual, but even rarer is the metastasis of one tumour to another. Most reports are based on evidence from autopsies; very few refer to surgical specimens. The most common primary tumour is pulmonary carcinoma and most frequent metastatic tumour is renal clear cell carcinoma. We present the case of a 54 year-old female with a past history of infiltrating ductal carcinoma of the breast with metastases in lung, lymph nodes and bone. Three months previously to her referral to us, she had developed a renal mass and underwent nephrectomy. Histopathology revealed a renal chromophobe cell carcinoma with intratumoral breast cancer metastasis. We describe the histopathological, immunohistochemical and molecular features and review the recent literature (AU)

Humanos , Feminino , Pessoa de Meia-Idade , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/patologia , Metástase Neoplásica/patologia , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/patologia , Diagnóstico Diferencial , Nefrectomia/métodos , Imuno-Histoquímica/métodos , Imuno-Histoquímica , Fotomicrografia/métodos , Carcinoma de Células Renais , Rim/patologia , Rim